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Anteayer Journal of Advanced Nursing

Which Aspects of Abortion Care Do Healthcare Practitioners in Britain Think Nurses/Midwives Should Provide? Findings From the SACHA Study

ABSTRACT

Aim

To explore the views of healthcare practitioners in Britain regarding the role of midwives and nurses in the delivery of medical and surgical abortion.

Design

An observational study of the Shaping Abortion for Change study healthcare practitioner survey (2021–2022).

Methods

Relationships between healthcare practitioner type, participant characteristics, knowledge of and attitudes towards abortion, and views about nurses' and midwives' role in abortion care were examined using Pearson's Chi-squared tests of association and multivariable logistic regression.

Results

Amongst 763 participants including doctors, nurses, midwives and pharmacists, 71.6% supported specialist nurses in sexual and reproductive health and abortion clinics and hospitals, expanding their roles to include prescribing abortion medications and surgical abortion methods. Support was lower for midwives (35.8%) and primary care nurses (32.5%). There was considerable support for all nursing and midwifery groups to be involved in adjacent tasks of abortion care. Differences in support by healthcare practitioner type persisted after adjustment for exposure variables.

Conclusion

There is strong support for specialist nurses to expand their role in abortion care. This change could be implemented following clarification of the legal position. Some healthcare practitioner groups are more reluctant to support broader involvement of nurses and midwives in abortion provision.

Implications for the Profession and/or Patient Care

Expanding specialist nurses' role in abortion care could increase service capacity and improve patient access and experience. Understanding and addressing the concerns of healthcare practitioners opposing this change is critical for successful implementation and patient safety.

Impact

This study addresses the potential for nurse and midwife role expansion in abortion care. The findings highlight broad support for specialist nurses whilst identifying barriers to wider role expansion. The research informs policy discussions on workforce optimisation and access to abortion services across Britain.

Reporting Method

This study adheres to the STROBE guidelines for reporting observational studies.

Patient or Public Involvement

In the SACHA study, patient and public involvement was included at all stages to inform study design, recruitment, data collection and analysis.

Key Features of Successful Research‐Related Roles for Nurses and Midwives in out of Hospital Settings: A Mixed Methods Approach

ABSTRACT

Aim

To explore the views of health care professionals involved in initiatives that have led to successful research-related roles for nurses and midwives working in community settings.

Design

A sequential mixed-methods study.

Methods

Between December 2022 and January 2023 a survey was completed by health care professionals with relevant experience of successful research-related initiatives for nurses and midwives in community settings. Survey responses were categorised into low, medium or high-priority examples of productive practice. Nineteen of the twenty responders who provided high-priority examples were interviewed between May and July 2023. The research capacity development for impact framework underpinned data collection and analysis. Data were thematically analysed using the framework method.

Results

The seven themes of the research capacity development for impact framework: leadership and sustainability, skills and confidence building, infrastructures, linkages and collaborations, ownership and responsibilities, actionable dissemination and co-production were identified as important features of successful research-related roles in community settings. A new cross-cutting theme of trust and relationships was generated. The initiation, continued growth and ambition continuum guided the development of the planning change and features of success template.

Conclusion

This study highlighted the key features that matter when planning change and developing research-related roles for nurses and midwives in community settings.

Impact

Study findings have the potential to inform policy and practice for organisations focused on developing research capacity and capability in community settings.

Reporting Method

This study adhered to the COREQ reporting guidelines.

Patient and Public Involvement

No patient or public involvement.

Safe, Sustainable and Ethical Recruitment of Internationally Qualified Registered Nurses to Australia

ABSTRACT

Aim

To critically examine the safety, sustainability and ethical dimensions of recruiting internationally qualified nurses to Australia. A Global Justice Framework focusing on the political ethics of care is applied to the complexity and practical application of issues raised by the urgent nursing workforce needs in the health and aged care sectors.

Design

A discursive paper based on a critical reading of the literature.

Methods

Based broadly on a narrative review, this paper provides a critical analysis of relevant literature identified through CINAHL and PubMed databases. These included peer-reviewed articles, government reports, international guidelines and policy documents. Key issues identified included patient safety, sustainability and ethical considerations pertaining to international nurse migration.

Findings

Australia has rigorous standards for assessing the professional competency of Internationally Qualified Registered Nurses to ensure safety. Challenges persist, however, regarding professional integration, retention and adherence to ethical recruitment practices. While nurse migration alleviates workforce shortages in Australia, it exacerbates healthcare deficits in source countries facing critical shortages. Sustainability concerns include ensuring long-term workforce stability and maintaining high-quality care standards. Bilateral agreements must consider the needs of both source and host countries.

Conclusion

Addressing Australia's nursing workforce shortages requires ethical and sustainable recruitment strategies. Workforce demands must be balanced to ensure global health equity while upholding public safety and professional standards for all countries.

Implications for the Profession and/or Patient Care

Ethical recruitment practices are essential for developing policies and practices that support internationally qualified nurses' professional integration and retention. Establishing robust support systems enables these nurses to adapt effectively to Australian healthcare settings. Strengthening retention strategies fosters workforce stability, minimises attrition and may contribute towards consistent delivery of high-quality and safe patient care.

Effectiveness of Organisational Strategies for Pressure Injury Prevention and Treatment in Acute Hospital Settings: A Systematic Review

ABSTRACT

Aim

To investigate the effects of organisational interventions on the incidence, healing and management of pressure injuries in adult patients in acute hospital settings.

Design

Systematic review.

Methods

The review included adult patients at risk of or with pre-existing pressure injuries in acute hospital settings, excluding mental health units, emergency departments or operating theatres. Interventions employed in the included studies were categorised using the Cochrane Effective Practice and Organisation of Care taxonomy.

Data Sources

Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Ovid Embase, EBSCO CINAHL Complete and Web of Science Core Collection were searched from 01 January 2012 to 31 December 2023.

Results

Of 8861 records identified, 7 prevention studies met the inclusion criteria. Six studies reported reductions in pressure injury incidence. Included studies employed various combinations of 14 organisational strategies to enhance practices. Educational interventions were utilised in six studies, including educational meetings, materials and outreach visits. Other common strategies included audit and feedback, communities of practice and continuous quality improvement. The interventions targeted patients and clinicians, primarily nurses, with some involving multidisciplinary teams. The focus was on enhancing healthcare practices through systematic approaches and stakeholder engagement.

Conclusions

Organisational strategies targeting both patients and clinicians as part of an intervention bundle may enhance the prevention of pressure injuries in acute hospital settings. Further, high-quality effectiveness–implementation hybrid trials are required to evaluate these strategies.

Implications for the Profession and Patient Care

Organisational factors influence clinicians' ability to implement evidence-based practices. The effectiveness of specific organisational strategies in acute settings is uncertain. Multiple organisational strategies targeting patients and clinicians may improve the implementability of a pressure injury prevention intervention.

Reporting Method

This study adhered to PRISMA guidelines.

Patient or Public Contribution

Neither patients nor the public were directly involved in this study.

Beyond the Technology: Nursing Critically Ill Children on Extracorporeal Organ Support—A Hermeneutic Review of the Literature

ABSTRACT

Background

Using advanced forms of medical technology such as extracorporeal organ support to take over organ function in the face of critical illness is a manifestation of the technological expertise to support and prolong life. However, clinician focus on the technical aspects of extracorporeal organ support both in research and clinical practice has the tendency to relegate to the background and disregard multiple, non-technical components such as the meanings, interactions, and experiences of nurses, families and other healthcare professionals.

Aim

To understand how experiences and social interactions of critically ill children, families, and healthcare professionals are influenced by the use of extracorporeal organ support.

Design

Hermeneutic review of the literature.

Data Sources

CINAHL, PubMed and Web of Science followed by cross-citations and snowballing.

Results

A total of 24 studies were included in the review, representing four conceptual streams, namely (1) extracorporeal organ support as a biomedical intervention, (2) relationality concerning extracorporeal organ support, (3) performativity in using extracorporeal organ support and (4) the agential role of extracorporeal organ support.

Conclusion

The hermeneutic framework helped foreground perspectives demonstrating that extracorporeal organ support is not merely a piece of medical technology, but is an active fulcrum upon which human and material elements revolve, interact, and integrate to form multiple assemblages that can influence how the huge volume of nurse work can be reframed beyond the perpetuation of the patient-machine connection and affect the ways by which patients and families are cared for.

Impact

Understanding extracorporeal organ support as more than a medical device can enable nurses to develop informed plans of care and advocate for the interests of the family and that of the critically ill child who remains a passive recipient of care in an intensive care bed.

Patient or Public Contribution

No patient or public contribution.

Recent Trends in Doctoral Theses in Nursing Across Eight Countries: A Scoping Review

ABSTRACT

Aim

To explore and map the landscape of doctoral nursing research across eight countries.

Design

A scoping review.

Methods

This review followed the Joanna Briggs Institute methodology for scoping reviews and included doctoral theses in nursing defended between 2020 and 2023 in Austria, Italy, Israel, the Netherlands, Poland, Portugal, Slovakia and the United Kingdom.

Data Sources

Searches were conducted across 15 national and university repositories (4 national, 11 university) in the eight participating countries.

Results

This review included 431 doctoral nursing theses, the majority of which employed quantitative methodologies and focused on patient populations and healthcare professionals. Key topics included clinical nursing care, quality of care, quality of life, home care, perinatal care and the work environments.

Conclusion

Nursing doctoral research shows progress in healthcare delivery, patient care and education via digital tools, holistic approaches and professional development. Yet gaps persist in mental health, paediatrics and marginalised groups. Limited qualitative/mixed-methods research and weak interdisciplinary collaboration reveal further opportunities.

Implications for the Profession and/or Patient Care

This review underscores that nursing doctoral research is addressing major healthcare and professional challenges. Nonetheless, the identified gaps emphasise the need for more comprehensive and inclusive research to enhance equity and guide future nursing practices and policies.

Impact

This review provides an overview of the scope of doctoral nursing research across eight countries, identifying key trends and research gaps. The findings are expected to inform nursing academia, policymakers, and healthcare professionals by guiding future research priorities, fostering interdisciplinary collaboration, and promoting equitable, patient-centred care practices.

Patient or Public Contribution

No direct involvement in data collection; one lay reviewer gave feedback on readability and practice implications, informing minor refinements.

‘We've Taken on a More Advanced Clinical Role’: A Multimethod Study of Community Nurses' Extended Roles in Palliative Care

ABSTRACT

Aim

To explore community nurses' experiences of changes to their roles in palliative and end-of-life care.

Design

An e-survey was followed by focus groups.

Methods

Fifty-one community nurses with recent experience of delivering end-of-life care in the United Kingdom completed a survey about changes to their roles. A purposive sample of 35 respondents participated in focus groups exploring these changes in more depth; thematic analysis was used with constant comparison.

Results

As well as two new roles—prescribing and verifying death—many participants talked about a broader expansion of their role, increasing their leadership in making complex end-of-life care decisions with patients and families. Most nurses expressed pride in their new knowledge and skills, and satisfaction with the care they were providing. Yet many also expressed distress that heavy workloads impaired their capacity both to provide good clinical care and to train junior colleagues. The importance of General Practitioner support with complex cases was often highlighted, but accessing such support was sometimes difficult.

Conclusion

While welcoming the opportunity to extend their palliative care roles, many participants indicated experiencing moral distress.

Implications for the Profession and/or Patient Care

Excessive workloads and patchy medical support threaten the retention of the experienced nurses upon whom community palliative care depends.

Impact

Our findings suggest that new and extended palliative care roles are viewed positively by nurses. To be sustainable, these changes require better workload management and consistent medical back-up.

Reporting

We adhered to relevant EQUATOR guidelines, using the SRQR checklist.

Patient or Public Contribution

Our Public and Clinician Advisory Group helped shape questions and commented on findings.

The Reported Evidence of Nursing and Midwifery Mentorship Programmes Internationally: A Scoping Meta‐Review Providing a Comprehensive Overview of Mentorship Programmes

ABSTRACT

Aim

To synthesise and critically analyse existing reviews of evidence on mentorship in nursing and midwifery, providing a comprehensive overview of current knowledge.

Design

A scoping meta-review.

Methods

The review was conducted using the scoping meta-review framework outlined by Sarrami-Foroushani et al. (2015), alongside the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines to ensure rigour and transparency. The following steps were included: (i) defining the problem, (ii) literature search and criteria, (iii) study selection and data extraction, (iv) data synthesis, (v) presentation of results and (vi) interpretation and recommendations.

Data Sources

A comprehensive search strategy was designed, utilising Boolean operators, truncation and predefined keywords across seven databases including MEDLINE, CINAHL, Embase, PsycINFO, Epistemonikos, ERIC and Google Scholar.

Results

Following double-blind screening of 269 papers, 14 literature reviews were included. The findings provided a detailed overview of mentorship programme types (formal and informal), outcome measures used to evaluate mentorship effectiveness and recommendations for future programmes. Identified themes included skill development, job satisfaction, career progression and retention outcomes, together with challenges including time constraints and balancing clinical responsibilities with mentorship roles. Formal mentorship programmes that are adequately supported and integrated into the organisational culture can improve healthcare systems, workforce stability and patient outcomes. Informal mentorship continues to offer valuable, flexible support, particularly when used alongside formal structures. Implementation challenges exist, such as time constraints, limited organisational support, and mismatched mentor-mentee pairings.

Conclusion

This review highlights the critical role of mentorship in nursing and midwifery, offering insights into effective practices, challenges and potential areas for further research. The findings suggest that formal, structured mentorship programmes produce consistent benefits, including enhanced clinical skills, confidence and satisfaction among mentees, as well as leadership development and professional fulfilment for mentors, while positively impacting organisational efficiency and patient outcomes. Successful mentorship programmes require organisational commitment, with protected time, resources, and ongoing mentor training.

Implications for the Profession and/or Patient Care

Mentorship programmes in nursing and midwifery enhance professional development, job satisfaction, and retention, enabling a stable healthcare workforce. Mentorship for mentors and mentees is linked to increased confidence, competency and readiness for advanced roles among nurses and midwives. Fostering mentorship in healthcare can lead to improved quality and continuity of care as mentees grow into more competent and confident practitioners.

Impact

Formal mentorship programmes that are adequately supported and integrated into the organisational culture can improve healthcare systems, workforce stability and patient outcomes. Policymakers responsible for healthcare workforce development can use these findings to advocate for mentorship as a strategic investment, potentially influencing policies related to nurse retention, professional development and funding allocations for mentorship initiatives. Structured mentorship improves job satisfaction, reduces turnover and fosters professional growth, thus reducing costs associated with recruitment and training.

Reporting Method

The findings are reported in line with the PRISMA guidelines (Page et al., 2021) and through a narrative synthesis, summarising and analysing the results of various reviews to present a cohesive understanding of mentorship practices in nursing and midwifery. This method allowed for the integration of qualitative and quantitative findings and the identification of common themes and patterns across studies.

Patient or Public Contribution

Patients or members of the public did not directly contribute to this review. However, by focusing on mentorship practices that support nurses and midwives, the study indirectly addresses public interests, as improved mentoring contributes to the quality of patient care. Future studies could benefit from patient or public feedback on desired qualities in care providers, further informing the development of mentorship programmes aligned with patient-centred care outcomes.

The Complexity of Emergency Nurse Retention and Turnover Pre‐ and Post‐Covid 19: A Scoping Review

ABSTRACT

Aims

To examine factors influencing emergency nurse turnover and retention pre- and post-COVID-19 and inform planned Participatory Systems Mapping research.

Design

A scoping review of the literature reporting reasons emergency nurses leave, intend to leave or stay.

Methods

Following the Joanna Briggs Institute methodology and a pre-registered protocol, databases and grey literature were systematically searched in January 2025 (updated August 2025). Literature published after 1st January 2010, was included. Two reviewers independently screened records, and 10% of extractions were cross-checked. Data were grouped thematically on a visual coding system using the Miro platform. Pre- and post-COVID-19 sources were categorised and analysed using a two-dimensional framework of intensity and frequency.

Data Sources

MedLine, CINAHL, PsycINFO, Web of Science, Cochrane and grey literature.

Results

Ninety-three sources were included. Burnout, workload, staffing and workplace violence (WPV) were linked across study designs to turnover, while job satisfaction, supportive leadership and team cohesion appeared to support retention. Problem-focused and resilience-based coping were associated with retention across study designs (n = 5); emotion-focused strategies were linked with poorer outcomes (n = 3). In a subset of 86 sources, traditional protective factors (leadership support and team camaraderie) appeared weakened post-COVID-19. A novel theme of moral obligation to remain, despite personal risk, emerged. Adaptive coping gave way to downshifting and emotional suppression.

Conclusion

The included evidence indicates that multiple, interacting factors shape emergency nurse turnover and retention, whilst systemic strategies aligning operational demands with psychological safety and core nursing values may contribute to sustainable retention.

Implications for the Profession

Workforce interventions should address the psychological legacy of COVID-19 and focus on rebuilding trust, flexibility and moral sustainability in emergency departments.

Impact

While individual drivers of turnover are known, their complex interplay and retention factors are underexplored. This review identifies themes transcending boundaries and recurring across the turnover pathway, underscoring the need for multi-level interventions relevant to both nurse managers and policy makers.

Reporting Method

Reporting follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines (PRISMA-ScR).

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct or reporting.

Exploring Clinicians' Perspectives of Transition From Hospital to Home for Older Adults Living With Frailty: TRANSFER‐I a Focus Group Study

ABSTRACT

Aim

To investigate clinicians' perspectives on the transition from hospital to home and identify gaps in care for older adults living with frailty during the transfer of care.

Design

Qualitative reflexive thematic analysis of focus groups

Methods

Focus groups were conducted with clinicians using purposive sampling. Participants were eligible if they had provided or overseen the clinical care of a patient transferring from hospital to home. Verbatim transcripts were analysed, and themes were identified using NVivo through the development of codes and exploration of core commonalities.

Results

A total of 28 clinicians participated in five focus groups. Participants included nurses (n = 14), allied health (n = 8), medical officers (n = 2), managers and hospital executives (n = 4). Themes were categorised into four domains: (1) system fragmentation and finite resources challenge healthcare navigation for everyone; (2) the interplay of cultural and societal considerations in the context of ageing; (3) fragile cycle of care for older patients who frequent hospitalisation; and (4) effective communication and expertise being critical for quality care.

Conclusion

Despite decades of research, the transition from hospital to home for older adults living with frailty remains a persistent challenge. This study identified significant and continued unmet needs in navigating a complex health system, underscoring the evidence-practice gap in transitional care services. Results have informed the development and implementation of a feasibility study (TRANSFER-II), currently underway, that tests the feasibility of a nurse-coordinated model of transitional care support for older adults.

Implications for the Nursing Profession and Patient Care

Transfers from hospital to home, frequent readmissions and transitions in care are common for older adults living with frailty. Understanding the enablers and barriers in transitional care for this vulnerable population can enhance the quality of care, improve communication and inform the development of more effective transitional care models. The findings underline the critical role nurses play in addressing systemic gaps and improving continuity of care for older adults across diverse health systems.

Impact

Transitional care is complex, and older populations are more at risk of returning to hospital. Findings highlight the significant unmet needs in navigating a complex health system and revealed the fragile cycle of care for older adults who frequent hospital. Reiterating the importance of effective communication and clinical expertise in delivering safe patient-centred nursing care.

Reporting Method

This qualitative study was reported in accordance with the consolidated criteria for reporting qualitative research (COREQ) checklist.

Patient or Public Contribution

Patients and carers contributed to the design of this qualitative study through consultation with a consumer advisory group, where potential transitional care interventions were discussed. These discussions highlighted a need to further explore transitional care unmet needs, informing the development of this focus group study.

General Dementia Training for the Social Care Workforce: A Systematic Review

ABSTRACT

Aim

The aim of this systematic review was to assess and synthesize the global evidence on existing general dementia training and education for the social care workforce.

Design

Mixed-methods systematic review.

Data Sources

Systematic searches on five databases (PubMed, APA PsychINFO, CINAHL Plus, Scopus, Web of Science) were conducted for articles published between 2010 and July 2024.

Methods

Each abstract and full text was screened by two research team members, with conflicts of inclusion dissolved by a third team member. Data were extracted and studies narratively synthesized by the group into comparisons of content, delivery mode, workforce and outcomes/impact.

Results

Twenty-seven studies from 13 mainly high-income countries were included in this review. Most studies provided training to care home staff, with studies using remote, in-person and blended training delivery modes. While the focus was on generic dementia education, various interventions have been evidenced in the social care workforce, to different effects. Most changes in outcomes were reported for staff knowledge and confidence, while evidence on impacts on people with dementia is limited and mixed.

Conclusion

There are various types of in-person and remote dementia training available for the social care workforce, with overall positive impacts on knowledge and change in care delivery. Evidenced interventions need to be implemented across countries and have the potential to improve dementia knowledge, particularly in lower- and middle-income countries where evidence and the social care workforce are limited.

Implications for the Profession and/or Patient Care

Findings provide clear recommendations on the value and benefit of diverse dementia training on the social care workforce, care delivery and limited but emerging evidence on service user outcomes. Nurses are key parts of the staff working in social care settings, including care homes and would thus benefit from the identified dementia training.

Patient or Public Contribution

Two former unpaid carers and three voluntary sector staff helped interpret the findings and reviewed drafts of the manuscript. They are co-authors.

Understanding Nurses' Intention to Use Artificial Intelligence Technologies in Their Clinical Practice: A Survey‐Based Configurational Analysis

ABSTRACT

Aims

The study focused on nurses' familiarity with, beliefs about, and attitudes towards artificial intelligence, aiming to identify configurations of necessary and sufficient conditions associated with strong intentions to use artificial intelligence-based health technologies in their clinical practice.

Design

Cross-sectional survey conducted online from mid-October 2023 through early February 2024.

Methods

The fuzzy set qualitative comparative analysis method was employed to analyse the survey data.

Data Source

307 members of the professional order of nurses in Québec province, Canada.

Results

Findings from the qualitative comparative analysis show that strong intentions to use artificial intelligence are only observed when nurses perceive artificial intelligence to have a high impactfulness on their future clinical practice (necessary condition). Moreover, we observe three configurations of sufficient conditions, that is, three combinations (artificial intelligence profiles) of familiarity with, belief about, trust in, and perceived impactfulness of artificial intelligence.

Conclusion

Current curriculum efforts have centred on defining artificial intelligence competencies, yet competency alone does not guarantee a willingness to adopt artificial intelligence tools. Our findings indicate that a positive attitude towards artificial intelligence's potential impact is crucial, with various profiles supporting intentions to adopt artificial intelligence.

Implications for the Profession

These findings suggest that nurses' preparation should go beyond developing artificial intelligence competencies and that nursing educators and trainers need to account for the different profiles associated with strong intentions to use artificial intelligence technologies. Training programmes and nursing curricula should prioritise shaping nurses' beliefs and attitudes about artificial intelligence rather than focusing solely on technical skills.

Impact

We contribute to nursing research by showing that a positive attitude towards artificial intelligence's impactfulness on nurses' future clinical practice is a necessary condition for having high intentions to use artificial intelligence technologies.

Reporting Method

Relevant guidelines have been adhered to by employing recommended qualitative comparative analysis reporting methods.

Patient or Public Contribution

No patient or public contribution.

Exploring the Design, Development, and Implementation of a Peer‐Led Community Café in Mental Health Service Provision: A Qualitative Descriptive Study

ABSTRACT

Aims

To explore the design, development, and implementation of a peer-led community café to support people in mental health crisis from the perspectives of key stakeholders in Ireland.

Design

Qualitative descriptive study.

Methods

Twelve individuals representing the Community Café Operations Team and Senior Healthcare Management took part in a stakeholder convening or individual interview between February and July 2023 in Ireland. Data was analysed using Burnard's thematic content analysis framework, and findings were mapped onto the RE-AIM framework. This process was supported by the involvement of a person with lived experience who had previously utilised the Community Café as a customer.

Results

Key findings identified in relation to the design, development and implementation of the Community Café included: person centredness, co-production, alternative service provision (out-of-hours), staff supports, challenges affecting sustainability, and governance issues.

Conclusion

Close collaboration among healthcare services, practitioners, service users and community partners is essential in developing mental health services, prioritising co-production and person-centred service delivery. Key components include out-of-hours service provision, staff support, sustainability, and governance. By addressing these areas, healthcare systems can better meet the needs of service users on their recovery journey.

Implications for the Profession and/or Patient Care

The findings generate new knowledge to inform the development of community and crisis cafes, improve service user outcomes, and support recovery. The results provide valuable insights into key stakeholder perspectives guiding the design, development, and implementation of peer-led community cafes, highlighting best practices to shape future initiatives.

Impact

The study provides valuable insights for policy makers, service developers, and care recipients by highlighting lessons learned from designing, developing, and implementing a peer-led Community Café. It showcases best practice in co-producing a peer-led service to address both service user and service needs.

Reporting Method

We used the COREQ guidelines for reporting qualitative studies.

Patient or Public Contribution

The study design was co-created with the Community Café Operations team, who contributed to the methods, interview schedule, and interpretation of findings. One team member (D.B.) worked in the Community Café, and a customer with lived experience of mental health difficulties helped contextualise and interpret the results.

Experiences of Irish Mentors and Mentees Engaged in a National Nursing and Midwifery Mentorship Programme: Mixed Methods Study With a Qualitative Focus on Mentors' Views

ABSTRACT

Aim

To gain an understanding of the experiences of mentors and mentees engaging in a national mentoring programme within nursing and midwifery in Ireland.

Design

A two-phased convergent parallel mixed methods study was undertaken.

Methods

The first phase was a quantitative non-experimental descriptive study using an online survey with mentors (n = 12) and mentees (n = 6). The second phase was a qualitative descriptive study and involved focus group discussions with mentors (n = 5). No mentees took part in the focus group discussions. There was a disproportionate representation of mentors versus mentees in the total sample across both phases of this study. Data were collected between December 2023 and April 2024.

Results

Mentorship has a positive impact on professional growth, job satisfaction and career development for both mentors and mentees in nursing and midwifery professions. Significant challenges to effective nursing and midwifery mentorship include time constraints, irregular work patterns and a need for additional managerial and structural support. Areas identified for improvement in programme implementation include clearly defined roles, dedicated time and space for mentorship meetings and tailored support systems to address cultural diversity.

Conclusion

This study highlights the significant benefits of a national formal mentorship programme; however, substantial barriers continue to underscore the need for strategic improvements. Addressing these challenges through clearer role definitions, dedicated protected mentorship time and culturally responsive support systems may enhance mentorship programme effectiveness and ensure long-term sustainability.

Patient or Public Contribution

None.

Implementation frameworks, strategies and outcomes in optimizing central venous access device practice in paediatrics: A scoping review

Abstract

Paediatric patients with complex or acute conditions may require a central venous access device, however, almost one-third of these devices have associated complications (e.g. infections). Implementation of evidence-based practices regarding central venous access devices can reduce and potentially prevent complications.

Aims

This scoping review aimed to explore recent interventional research in CVAD management through an implementation lens.

Design

This scoping review used the Arksey and O'Malley framework. Studies were included if they were written in English, published in 2012 to July 2023, involved children and were relevant to the study aims. Risk of bias was appraised by the Mixed Methods Appraisal Tool.

Data Sources

Searches were undertaken in EMBASE, CINAHL (Ebsco), PubMed, Web of Science and Cochrane Library (CENTRAL).

Results

Of the 1769 studies identified in a systematic search, 46 studies were included. Studies mostly focused on health professionals and central venous access device maintenance and had quantitative pre-post study designs. Adherence to implementation frameworks was lacking, with many studies employing quality improvement approaches. Implementation strategies were typically multipronged, using health-professional education, bundles and working groups. Bundle compliance and reductions in central line-associated bloodstream infections were the most featured outcomes, with most studies primarily focusing on effectiveness outcomes.

Conclusion

Translation of evidence-based practices to the clinical setting is difficult and current adoption of implementation frameworks (apart from ‘quality improvement’) is limited. Implementation strategies are diverse and dependent on the local context, and study outcomes typically focus on the effectiveness of the physical intervention, rather than measuring the implementation effort itself.

Implications for Patients

Future intervention research requires a more uniform and deliberate application of implementation frameworks and strategies.

Impact

Greater exploration of relationships between frameworks and strategies and implementation and service outcomes is required to increase understanding of their role in maximizing resources to improve health care.

Adhered to best reporting guidelines as per PRISMA-ScR (Tricco et al., 2018).

Patient or Public Contribution

No patient or public contribution.

Perceptions of Trans and Gender Non‐Conforming People on General Health Care in the Being LGBTQI+ in Ireland Study

ABSTRACT

Aim

To examine if trans and gender non-conforming participants perceive greater healthcare inequities in their interactions with healthcare practitioners than cisgender sexual minority participants, and analyse free text responses from transgender and gender non-conforming participants to gain possible insight into causes of inequities.

Design

A cross-sectional study.

Methods

An anonymous online survey of over 2800 self-selecting LGBTQI+ participants, 30% of whom identified as trans and gender non-conforming. The research team devised closed and open-ended questions about perceptions of healthcare provision and analysed quantitative responses using SPSS and open-ended data through thematic analysis.

Results

Over half of trans and gender non-conforming participants reported having had occasion to educate healthcare professionals about LGBTQI+ identities and a majority reported that healthcare professionals made incorrect assumptions about their LGBTQI+ identity. Invalidation and pathologisation of participants' trans and gender non-conforming identity and unhelpful therapeutic approaches were some of the negative health experiences cited.

Conclusion

Trans and gender non-conforming populations experience significant barriers to healthcare relative to their cisgender sexual minority peers. Cisnormative thinking in healthcare practice together with a lack of knowledge of trans and gender non-conforming people's experiences leads to substandard care and acts as a barrier to disclosure and help seeking.

Implications

Culturally responsive healthcare is critical to ending health inequities experienced by trans and gender non-conforming people.

Impact

Problem addressed: Healthcare inequities among trans and gender non-conforming participants.

Main findings: Trans and gender non-conforming participants reported more negative perceptions of their healthcare experiences compared to cisgender sexual minority participants.

Where and on whom will the research have an impact? Healthcare educators/practitioners.

Reporting Method

Strobe.

Public or Patient Contribution

Members of the LGBTQI+ community were part of the research advisory group and inputted into paper authorship.

Paper Contribution to the Wider Global Clinical Community

Highlights the need for training to increase cultural competency among healthcare providers.

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